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The classification of apraxia(Liepmann)from a new viewpoint Mitsuru Kawamura 1 1Department of Neurology, Showa University School of Medicine Keyword: 失行 , apraxia , 頭頂葉 , parietal lobe , 行為記憶 , memory of voluntary action pp.637-647
Published Date 2004/8/10
DOI https://doi.org/10.11477/mf.1431100219
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 A first classification and comprehensive theory on the neural mechanism of apraxia was presented by Liepmann(1920)with several schematic diagrams. Since then, a number of studies on the mechanism of apraxia have been carried out, although none of these seem to have surpassed the work of Liepmann and its comprehensive content.

 In this article I will present some of my own cases, which exemplify the validity of the Liepmann schemata of apraxia, and some comments are made from a new viewpoint. I will then go on to propose the classification of apraxia(Liepmann)from a new viewpoint.

 1.Actions and their disturbances

 The author classifies actions into 9 categories:reaching, grasping, pantomime, imitation, using tools, construction, dressing, writing and speech. Apraxia is found in each action.

 2.The parietal lobe and memory of voluntary actions

 Disturbances in these actions are found in parietal lobe lesions, whether the lesion is in the left or the right lobe. These facts show that the parietal lobe retains the memory of voluntary actions.

 3.The parietal lobe and frontal lobe

 The author(1992, 1994)investigated disturbances of action found in seven cases with lesions in the anterior frontal lobe and compared them with disturbances of action in ideational/ideo-motor apraxias(Liepmann). Based on the results of this investigation, a hypothesis was obtained on the neural mechanism for voluntary action. This hypothesis suggested that the frontal lobe has an inhibitory function which relates to performing actions, and the parietal lobe has an excitatory function.


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1243 印刷版ISSN 0001-8724 医学書院

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